HomeMy WebLinkAboutDrain Layers Permit 192 Oak Street (2) .z TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 304
e , 19
Pursuant to written appl'Eation PeTm on is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
� 4 .
on the
�etween
�,:..
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for _ occupancy or use,
with .:aL Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE', INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 19 y =
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit,add'the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
4-0
Signed
Connection Charge Paid .$ ,. Licensed Drai Layer
tn (,qig)
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED Z; is�f ' j�#*i<' (Date)
r wk (Sig)
IN P CTOR